Culture, Environment, and Food to Prevent Vitamin A Deficiency (International Nutrition Foundation for Developing Countries - INFDC, 1997, 208 pages): Part IV. Understanding Vitamin A deficieny in the community: 9. The contexts of culture, environment, and food: Keys to finding local community food sources to prevent Vitamin A deficiency: What foods are available and how much vitamin a do they contain?

Culture, Environment, and Food to Prevent Vitamin A Deficiency (International Nutrition Foundation for Developing Countries - INFDC, 1997, 208 pages)

(introductory text...)

Preface

Acknowledgements

Contributing authors

Part I. Vitamin A in food and diets

1. Vitamin A and food: The current situation

(introductory text...)

Overview: What this book is about

The Vitamin A situation

Proposed solutions to the problem

Focused ethnography to understand local culture and environment for Vitamin A programs

The structure of this book

2. The complexities of understanding Vitamin A in food and diets: The problem

(introductory text...)

Introduction

Overview of natural Food sources of Vitamin A

Vitamin A food composition data

Effect of food processing on Vitamin A

Food composition tables for Vitamin A

Assessment of dietary Vitamin A intake

Dietary Vitamin A intake patterns

Other dietary and health factors influencing Vitamin A status

Programs that improve intake of Vitamin A-rich food

Summary

Part II. Creating the protocol

3. Theory and process: The methods

(introductory text...)

The International Union of Nutritional Sciences, committee on nutrition and anthropology

Theory of the methodological approach

Overview of methods of data-collection described in the protocol manual

Testing the protocol

Comment

Part III. Assessing natural food sources of Vitamin A in the community

4. The Philippines: The Aetas Canawan during wet and dry seasons

(introductory text...)

The Vitamin A problem in the Philippines

The Aetas of Canawan, Morong

The Aeta's way of life

Concepts of food and deficiency

Factors affecting food intake

A typical meal

Suggested dietary modifications

5. Community assessment of natural food sources of Vitamin A in Niger: The hausas of Filingué

(introductory text...)

Background discussion of Niger

Food sources of Vitamin A

Meal patterns and food utilization

Cultural beliefs about Vitamin A-rich foods

Vitamin A deficiency

Summary and recommendations

6. China: The people of Doumen Village, Kai Feng Municipality, Henan Province

(introductory text...)

Background and introduction

Eating Vitamin A-rich vegetable food

Cultural beliefs regarding key foods

Food patterns

Food preparation

Nightblindness

7. Peru: The rural community of Chamis and the urban suburb of San Vicente in Cajamarca

(introductory text...)

Introduction

Overview of the location

Food sources of Vitamin A

Principal differences between Chamis and San Vicente

Family and individual food patterns

Feeding patterns by age gender

Vitamin A-rich food patterns

Cultural beliefs

Vitamin A and health

Summary and conclusions

Policy recommendations

Recommendations for research

8. India: The rural community of Sheriguda in Andhra Pradesh

(introductory text...)

Introduction

Team members and task

Current status of the problem

Study population

Community food sources

Food consumption pattern

Cultural/ecological pattern

Summary and policy strategies

Part IV. Understanding Vitamin A deficieny in the community

9. The contexts of culture, environment, and food

(introductory text...)

Overview

Overall performance of the protocol

Keys to finding local community food sources to prevent Vitamin A deficiency: What foods are available and how much vitamin a do they contain?

Keys to understanding consumption patterns of vulnerable groups

Keys to beliefs and perceptions about food

Keys to cultural, ecological and socioeconomic factors that constrain consumption of Vitamin A-rich food and prevention of deficiency

Keys to explanations and understandings of Vitamin A deficiency symptoms

Looking to the next steps: From ethnography to intervention design

References

Keys to finding local community food sources to prevent Vitamin A deficiency: What foods are available and how much vitamin a do they contain?

Keys to understanding the available foods that can be used to prevent vitamin A deficiency are found in the key-informant interviews and the free list of foods, in the market surveys, and in the community food system data tables. In addition, information is found in the background materials on the historical, ecological, and cultural setting for the community food system.

In addition to an examination of vitamin A content (retinol or carotene), food resource data needs to include information on preservation and preparation methods, as these affect nutrient levels. The manual facilitates collection of this type of information. For example, the study report from Niger includes the description of the long cooking processes for leafy vegetables, information that is important for evaluating the food supply as consumed. Studies also should note the sources of data on nutrient composition. Thus, it is useful to find in the report on Sheriguda village that the information in the food system data tables is based on food composition studies that were conducted with the current, advanced method of analysis (HPLC) in national laboratories.

In the field studies, the community food system data tables proved to be a valuable means of summarizing the local situation. Among the Aetas in the Philippines, the table contained 128 food items. One hundred sixty one species are on the list for the periurban site in Peru, with seventy-four in the rural area; thirty-seven species are listed for Filingué, Niger; thirty-five in Doumen village, China; and forty-five for Sheriguda village in India. Although some areas had unidentified species with unknown vitamin A content, vitamin A-rich foods were identified in all the systems. The data tables also provided information on key sources of protein, fat, and other nutrients that are important in the prevention of vitamin A deficiency.

Information on seasonality is obtained from the community food system data tables, market surveys, and key-informant interviews. For example, the study revealed that in Sheriguda village, pumpkin is available only during one short period during the year, while bachali (Basella alba), that is cooked with dahl, is available all year in local gardens, does not have to be purchased, and is an excellent source of carotene. Mango is popular with young children but is available for only two to three months. Papaya has a longer period of availability, but there are cultural barriers to its use (see following section, "Keys to Beliefs and Perceptions About Food").

Several field study reports pointed out the importance of paying special attention to how wild greens and leafy green vegetables are used. These species may be locally regarded as substantive food items or as condiments that are used in much smaller quantities. Greens may be dried and reserved as emergency or famine foods or preserved for use in herbal remedies. It is important to note preparation and preservation techniques. In Sheriguda village, another factor that affects use of greens is whether they are subject to infestation by insects or worms, in which case the food is rejected.

The market survey reports provided a valuable source of data on both availability and price of important food items. As discussed further below, excellent sources of vitamin A-containing foods are found in local markets, but their prices may be prohibitive for those most at risk of deficiency. By including calculations of price-per-serving and the price per 1000 RE, the study provided a perspective on true availability, particularly when the average family daily wage or food expenditure total was known. Liver is a good example; in all five research areas' it was recognized as an excellent food, good for the eyes, and for protecting health. However, it was not available regularly from home animal production, and was not purchased often because of its cost.